Mental Health Case Manager I
Raleigh, NC · On-site
Overview Supports patients and families in managing mental health and substance use concerns ... Assists with insurance appeals and utilization reviews. Supports clinical staff with coverage ...
Mental Health Case Manager I
Raleigh, NC · On-site
Overview Supports patients and families in managing mental health and substance use concerns ... Assists with insurance appeals and utilization reviews. Supports clinical staff with coverage ...
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... Monitor daily census and assignment to assure all patients are assessed for case management needs ...
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... Monitor daily census and assignment to assure all patients are assessed for case management needs ...
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... Monitor daily census and assignment to assure all patients are assessed for case management needs ...
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... Monitor daily census and assignment to assure all patients are assessed for case management needs ...
Mental Health Case Manager I
Raleigh, NC · On-site
Overview Supports patients and families in managing mental health and substance use concerns ... Assists with insurance appeals and utilization reviews. Supports clinical staff with coverage ...
Mental Health Case Manager I
Raleigh, NC · On-site
Overview Supports patients and families in managing mental health and substance use concerns ... Assists with insurance appeals and utilization reviews. Supports clinical staff with coverage ...
RN Care Manager - Rex Case Management Services
Raleigh, NC · On-site
$35.87 - $51.57/hr
As necessary meet with the Utilization Manager (UM) and SW after the meeting to discuss updates and ... Rex Case Management Services Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $35 ...
RN Care Manager - Rex Case Management Services
Raleigh, NC · On-site
$35.87 - $51.57/hr
As necessary meet with the Utilization Manager (UM) and SW after the meeting to discuss updates and ... Rex Case Management Services Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $35 ...
Demonstrate knowledge and skills necessary to provide case management services to the patient ... Knowledgeable in utilization review, medical terminology, appropriate levels of care, treatment ...
Demonstrate knowledge and skills necessary to provide case management services to the patient ... Knowledgeable in utilization review, medical terminology, appropriate levels of care, treatment ...
Utilization and Quality Management/Outcomes experience preferred. Previous work experience with a ... Prior experience in case management, home health, discharge planning, or Concurrent review.
Utilization and Quality Management/Outcomes experience preferred. Previous work experience with a ... Prior experience in case management, home health, discharge planning, or Concurrent review.
RN Case Manager, Full-time
Raleigh, NC · On-site
RN Case Manager, Full-time The schedule for this role is Monday-Friday 8 am to 5 pm. This is a ... and coordinate the appropriate utilization of contract services. * Participate in the ...
RN Case Manager, Full-time
Raleigh, NC · On-site
RN Case Manager, Full-time The schedule for this role is Monday-Friday 8 am to 5 pm. This is a ... and coordinate the appropriate utilization of contract services. * Participate in the ...
The Executive Director works closely with leaders from various departments-case management ... Responsibilities : 1. Utilization Management - Develop and lead a system-wide utilization ...
The Executive Director works closely with leaders from various departments-case management ... Responsibilities : 1. Utilization Management - Develop and lead a system-wide utilization ...
Remote Registered Nurse (RN) Case Manager
Raleigh, NC · Remote
$50K/yr
Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote work ...
Remote Registered Nurse (RN) Case Manager
Raleigh, NC · Remote
$50K/yr
Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote work ...
Remote Registered Nurse (RN) Case Manager
Raleigh, NC · On-site +1
$50K/yr
Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote work ...
Remote Registered Nurse (RN) Case Manager
Raleigh, NC · On-site +1
$50K/yr
Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote work ...
Travel RN Care Manager - $2,094 per week
Chapel Hill, NC · On-site
$2.0K/wk
Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...
Travel RN Care Manager - $2,094 per week
Chapel Hill, NC · On-site
$2.0K/wk
Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...
RN Case Manager, Full-time
Raleigh, NC · On-site
... and coordinate the appropriate utilization of contract services. * Participate in the ... the management team to support a safe and effective work environment Requirements * Registered ...
RN Case Manager, Full-time
Raleigh, NC · On-site
... and coordinate the appropriate utilization of contract services. * Participate in the ... the management team to support a safe and effective work environment Requirements * Registered ...
... and coordinate the appropriate utilization of contract services. * Participate in the ... the management team to support a safe and effective work environment Requirements * Registered ...
Quick apply
... and coordinate the appropriate utilization of contract services. * Participate in the ... the management team to support a safe and effective work environment Requirements * Registered ...
Provides direct patient care as necessary to include case management, Oasis care planning, assigning Care staff, and ensuring the efficient, effective utilization of existing staffing resource. Job ...
Provides direct patient care as necessary to include case management, Oasis care planning, assigning Care staff, and ensuring the efficient, effective utilization of existing staffing resource. Job ...
Provides direct patient care as necessary to include case management, Oasis care planning, assigning Care staff, and ensuring the efficient, effective utilization of existing staffing resource. Job ...
Provides direct patient care as necessary to include case management, Oasis care planning, assigning Care staff, and ensuring the efficient, effective utilization of existing staffing resource. Job ...
Provides direct patient care as necessary to include case management, Oasis care planning, assigning Care staff, and ensuring the efficient, effective utilization of existing staffing resource. Job ...
Provides direct patient care as necessary to include case management, Oasis care planning, assigning Care staff, and ensuring the efficient, effective utilization of existing staffing resource. Job ...
HOSPICE CLINICAL MANAGER - RN
Durham, NC · On-site
Provides direct patient care as necessary to include case management, Oasis care planning, assigning Care staff, and ensuring the efficient, effective utilization of existing staffing resource. Job ...
HOSPICE CLINICAL MANAGER - RN
Durham, NC · On-site
Provides direct patient care as necessary to include case management, Oasis care planning, assigning Care staff, and ensuring the efficient, effective utilization of existing staffing resource. Job ...
... involving case discussions, clinical rounds, appeals, and the Medical Policy, Quality, and Utilization Management Committees * Provide clinical guidance and leadership to promote collaboration ...
... involving case discussions, clinical rounds, appeals, and the Medical Policy, Quality, and Utilization Management Committees * Provide clinical guidance and leadership to promote collaboration ...
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... Case management needs including care coordination/transition and discharge planning, consultations ...
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... Case management needs including care coordination/transition and discharge planning, consultations ...
Utilization Case Manager information
See Raleigh, NC salary details
$16.12 - $19.97
3% of jobs
$19.97 - $23.81
1% of jobs
$23.81 - $27.66
6% of jobs
$29.51 is the 25th percentile. Wages below this are outliers.
$27.66 - $31.50
30% of jobs
The median wage is $32.89 / hr.
$31.50 - $35.35
26% of jobs
$36.81 is the 75th percentile. Wages above this are outliers.
$35.35 - $39.19
22% of jobs
$39.19 - $43.04
3% of jobs
$43.04 - $46.88
0% of jobs
$46.88 - $50.73
5% of jobs
$50.73 - $54.57
2% of jobs
$54.57 - $58.42
1% of jobs
$16
$35
$58
How much do utilization case manager jobs pay per hour?
As of Jun 29, 2026, the average hourly pay for utilization case manager in Raleigh, NC is $35.47, according to ZipRecruiter salary data. Most workers in this role earn between $28.75 and $37.40 per hour, depending on experience, location, and employer.
What is a Utilization Case Manager?
A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.
What does a utilization case manager do?
A utilization case manager reviews and authorizes healthcare services to ensure they are necessary and appropriate, often working with medical providers and insurance companies. They analyze patient records, coordinate care plans, and ensure compliance with policies, typically using case management software and clinical knowledge. Their goal is to optimize resource use while maintaining quality patient care.
What jobs pay 10,000 a month without a degree?
Utilization Case Managers typically do not earn $10,000 a month without specialized experience or certifications; most roles in this field pay lower salaries. High-paying jobs that can reach this level without a degree include sales, real estate, or entrepreneurship, often requiring strong skills, networking, and industry knowledge. Some trades, like certain construction or technical roles, may also offer high earnings with experience and certifications rather than formal degrees.
How does a Utilization Case Manager typically collaborate with healthcare providers and insurance companies?
Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.
What jobs pay 2000 a day?
Utilization Case Managers typically do not earn $2,000 a day; such high daily earnings are more common in specialized roles like senior executives, certain consulting positions, or high-level medical professionals. Most jobs with high daily pay require advanced skills, certifications, or extensive experience, and earnings can vary based on industry, location, and workload.
Is being a MOA a good entry level job?
A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative skills, familiarity with medical terminology, and sometimes certification. It provides experience in healthcare settings and can serve as a stepping stone to more advanced medical roles, but it may have limited responsibilities compared to specialized positions.
What are the key skills and qualifications needed to thrive as a Utilization Case Manager, and why are they important?
To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.
What is the difference between Utilization Case Manager vs Utilization Review Nurse?
| Aspect | Utilization Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, case management certification | RN license, certification in utilization review |
| Work Environment | Case management teams, hospitals, insurance companies | Utilization review departments, hospitals, insurance providers |
| Primary Focus | Coordinating patient care, discharge planning, resource allocation | Assessing medical necessity, reviewing patient records for appropriateness |
| Common Usage | Broader case management roles, patient advocacy | Specific review of medical necessity and insurance claims |
While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.
What are popular job titles related to Utilization Case Manager jobs in Raleigh, NC? For Utilization Case Manager jobs in Raleigh, NC, the most frequently searched job titles are:
- Remote Telephonic Nurse Case Manager
- Utilization Management
- Behavioral Health Case Manager
- Remote Telephonic Nurse
- Senior Case Manager
- Evening Optum Health Utilization Review
- Telephonic Nurse Case Manager
- Temporary Admission Discharge Nurse
- Full Time Behavioral Health Utilization Review
- 3Rd Shift Behavioral Health Utilization Review
What job categories do people searching Utilization Case Manager jobs in Raleigh, NC look for? The top searched job categories for Utilization Case Manager jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Utilization Case Manager jobs? Cities near Raleigh, NC with the most Utilization Case Manager job openings:
WakeMed rating
7.9
Based on 132 frontline employees who took The Breakroom Quiz
105th of 877 rated healthcare providers
Job description
Overview
Supports patients and families in managing mental health and substance use concerns, assisting with discharge planning, resource navigation, and community engagement. Serves as a resource and placement specialist, ensuring timely referrals, warm handoffs, and effective communication. Provide education, advocacy, and support to enhance patient self-management and recovery. Facilitates inpatient and outpatient connections, monitors placements, conducts safety assessments, arranges transportation, and addresses social determinants of health. Acting as a liaison between patients, families, providers, and community resources. Proactively works to prevent delays in care and disposition. Reviews patient admissions and continued stays for appropriateness, monitors insurance benefits, and ensures care aligns with coverage to optimize payment. Assists with insurance appeals and utilization reviews. Supports clinical staff with coverage guidance and medical record reviews. Participates in the involuntary commitment process, including case tracking and representing the hospital in hearings. Must be able to work independently, prioritize tasks, and manage time efficiently. Demonstrates a flexibility in accepting diverse work assignments, managing stress related to change, and resolving conflicts effectively.
Department Description
Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org .
EOE
Licensure
Not Applicable
Education
Master's Degree Counseling Or Marriage and Family Therapy Or Psychology Or Social Work Required
Experience
No Experience Required
Supports patients and families in managing mental health and substance use concerns, assisting with discharge planning, resource navigation, and community engagement. Serves as a resource and placement specialist, ensuring timely referrals, warm handoffs, and effective communication. Provide education, advocacy, and support to enhance patient self-management and recovery. Facilitates inpatient and outpatient connections, monitors placements, conducts safety assessments, arranges transportation, and addresses social determinants of health. Acting as a liaison between patients, families, providers, and community resources. Proactively works to prevent delays in care and disposition. Reviews patient admissions and continued stays for appropriateness, monitors insurance benefits, and ensures care aligns with coverage to optimize payment. Assists with insurance appeals and utilization reviews. Supports clinical staff with coverage guidance and medical record reviews. Participates in the involuntary commitment process, including case tracking and representing the hospital in hearings. Must be able to work independently, prioritize tasks, and manage time efficiently. Demonstrates a flexibility in accepting diverse work assignments, managing stress related to change, and resolving conflicts effectively.
Department Description
Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org .
EOE
Licensure
Not Applicable
Education
Master's Degree Counseling Or Marriage and Family Therapy Or Psychology Or Social Work Required
Experience
No Experience Required
About WakeMed
Sourced by ZipRecruiter
Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care.
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Raleigh, NC, US
Year founded
1961